Follicle fall out: beating baldness

There's no doubt the market for baldness cures exists. Elton John, who underwent hair transplant surgery, shows how far some men will go to disguise hair loss. But is there really any way to combat a loss of hair? And is it something men should even be bothered about?

Why does hair loss happen?

A certain amount of hair loss is normal – most people lose between 50 and 100 hairs a day, which fall out naturally to be replaced by new growth.

Advertisement - Continue Reading Below

But new hair growth slows down as we age, which may lead to thinning and eventually baldness.

Male pattern baldness, which is hereditary, usually occurs in middle-aged men but can also affect men in their late teens.

Hair-raising treatments

Despite the variety of products on offer, according to Marilyn Sherlock, chairman of the Institute of Trichologists, only two treatments have been shown to be of some use.

Marilyn says: 'I noticed fairly recently something like 300,000 applications for miracle cures in the US. That being the case, only two that we know of – minoxidil and finasteride – have had full clinical trials.'

Minoxidil

Minoxidil (Regaine) is rubbed into the scalp and is supposed to produce new growth. Marilyn says: 'It does in a few people I believe – I haven't actually seen it myself. What I have seen is that it reduces hair loss in those that are shedding; in the young man starting to lose his hair, it seems to put the brakes on.'

However, men who start using it have got to stay with minoxidil, adds Marilyn. 'The disadvantage is that it is effectively cosmetic, because once you stop the hair falls out anyway.'

Another consideration is that the effectiveness of minoxidil appears to wear off within about five years. But, Marilyn says: 'It's a step in the right direction and it's been clinically trialled, so it's worth looking at.'

Finasteride

Finasteride (Propecia) is taken in tablet form and, according to Marilyn, is 'showing itself to be quite useful'. The drug is not available on the NHS, but men can obtain it privately from their GP.

Hair replacement surgery

Another option is hair replacement surgery. This involves transplanting plugs of skin from areas of the scalp that still have hair to those that don't.

Advertisement - Continue Reading Below

Several sessions may be required, depending on the size of the bald patch. And it may be a couple of years before the final results can be seen.

A less painful option could be to invest in a hairpiece or toupee, hair extensions or hair weaving.

Of course, there are many other treatments that claim to work. But Marilyn says their effectiveness is usually only supported by testimonials rather than science. 'As soon as I find that you can't get any clinical evidence, one must forget it.'

Consulting a specialist

Men who are concerned about male pattern hair loss can consult a trichologist – a specialist who helps people who have problems with their hair or scalp.

Marilyn says: 'We can guide them, depending on the age at which they present. For example, the man that appears at the age of 40 saying he's going thin - his chances of going totally bald in old age are much less than a young man of 20 with the same problem.'

A trichologist can offer advice about diet and using the right sort of shampoo. Marilyn says: 'While diet has no direct effect on male pattern hair loss, if you have got male pattern hair loss and are eating badly, you will speed it up.'

One thing Marilyn often does with men using minoxidil or finasteride is to take scalp measurements so they can see whether the treatment is helping.

According to Marilyn, trichologists provide the advice and guidance that men often want. Sometimes they only want someone to listen.

Marilyn rarely sees a man with male pattern baldness more than once. 'Often I see them coming in with wads of adverts for the miracle cures. They want to know what basis there is for these adverts. It's just general advice.'

Boldly bald

To some men, losing their hair is a traumatic experience and they feel they must do something, anything, to either prevent it or replace the hair they've lost. But while many men spend time and money looking for a full head of hair, there are others who are living happily with baldness.

Dr Hugh Bethell, a Hampshire GP, says that on the whole men tend not to consult their doctor about male pattern baldness. 'Most accept it as part of their masculine virility', he says.

Jon Summers, 50, a business development director in Berkshire, noticed his hairline was receding when he was 18. 'I knew it was going to happen, because of the familial history, so it was no great surprise.

'I can't really remember my father with hair, and it never bothered him particularly.

'I suppose there was a little bit of adolescent vanity that was punctured, but no more than that.'

Despite the array of treatments on offer, he hasn't been tempted to try them so far. 'I think if I had a lot of money and a great deal of confidence in the end result, then yes, I would consider it, because I think it would be nice to have a full head of flowing locks again.

'But you see these old guys and, by and large, they don't look good. They look like some old bald guy with something plastered on their head.'

NetDoctor, part of the Hearst UK wellbeing network
Netdoctor participates in various affiliate marketing programs, which means we may get paid commissions on editorially chosen products purchased through our links to retailer sites.